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Cumberland County Health Department VACCINE REGISTRATION FORM (018 years of age) PATIENT INFORMATIONPatients First Names this your legal name? Middle Name not, what is your legal name? Yes No Race:
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The Cumberland County Health Department is a government agency responsible for promoting and protecting the health of residents in Cumberland County.
All healthcare providers and facilities operating in Cumberland County are required to file with the health department.
The form can be filled out online on the Cumberland County Health Department website or submitted in person at their office.
The purpose of the Cumberland County Health Department is to monitor and improve public health, prevent diseases, and provide healthcare services to the community.
Information such as patient demographics, diagnosis, treatment provided, and outcome must be reported on the form.
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